Connor John Bombaci, PT, DPT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

25703 Issued in MA

Practice address

4 Middlesex Rd
Tyngsboro, MA 01879-2020

Phone

(978) 219-4001

NPI assigned

Sep 3, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1760150635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ROSE CIR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019605209",
            "telephone_number": "978-595-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MIDDLESEX RD",
            "city": "TYNGSBORO",
            "state": "MA",
            "postal_code": "018792020",
            "telephone_number": "978-219-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBACI",
        "first_name": "CONNOR",
        "middle_name": "JOHN",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "25703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "connor@barbelltherapyandperformance.com",
            "affiliation": "N",
            "endpointDescription": "Encrypted Company Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Encrypted Company Email",
            "address_1": "4 Middlesex Rd",
            "city": "Tyngsboro",
            "state": "MA",
            "country_code": "US",
            "postal_code": "018792020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Tyngsboro, MA
• Providers in Tyngsboro, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.